My 73 year old father is complaining of sharp pain behind his

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My 73 year old father is complaining of sharp pain behind his eyes. This is 3 days after having an extremely hard hit to his head and visiting the er. The CT they did on Tuesday showed no bleeding, but did indicate some swelling. The new pain behind his eyes only started today. In addition, he is running a fever of 100.5 that has been present for the last few days; however, only comes in the evening. His blood work came out fine. My father is not someone to ever complain of pain, so I feel like this new pain behind his eyes is significant. Do you think we should return to the ER tonight?

Doctor DanB :Hello and thanks for your question. Is he having altered sensorium or consciousness? Are the eyes red or is he nauseous?

Customer:

He is not having altered consciousness. There is no change in his mental status, and he is not nauseous. His eyes are a little red. The only other symptom is his fever. He never complains of head aches, so I'm just concerned this could be related to his previous fall.

Doctor DanB :I assume his vision is the same? Is he otherwise having headaches or a stiff neck? Is there anything that makes his eye pain better?

Doctor DanB :Are you still there?

Customer:

I'm sorry, I've been speaking to him on the phone. His vision is the same, and his neck isn't stiff. Do you think this could be a head ache as a result of a concussion? He also has been very lethargic.

Doctor DanB :Yes, I do think this is the result of the concussion. Did he lose consciousness? So the CT scan found swelling of his brain?

Customer:

No, he didn't lose consciousness - but we really don't know what happened exactly. My mom was sleeping and he got up in the middle of the night and evidently walked into a wall. I wasn't present when they gave my parents the CT results, but my Mom said that they said there was no bleeding. She did say they could see where he hit on the CT - but I'm not sure what that meant. I assumed there had to be some swelling for them to see anything.

Doctor DanB :Okay I see. It sounds like maybe there was a contusion (bruise/swelling) in the scalp; I suspect that if there was swelling in the brain that would be a major issue that would've been conveyed.

Customer:

So - do you think we're ok for tonight? I know that's hard to answer without seeing someone. My father absolutely never complains - so I always know its significant if he says anything. He also has never had a head ache, so I feel like this must be related to the fall. He was also very active today, so I'm wondering if that made things worse. If he did have a mild concussion, having a head ache and being lethargic could be expected right?

Doctor DanB :If he had a mild concussion, then yes, both of those could be expected. However, if his lethargy is out of proportion to the degree of work he did today, then I would at least call the ER and speak to the triage nurse about it. Does that make sense?

Customer:

That helps! Thanks! I'm encouraging him to stay in bed tomorrow and rest up. His pain is getting better now after taking ibuprofen, so is that a good sign too?

Doctor DanB :Yes, that is a good sign. Do you have any other concerns or questions about this topic?

Customer:

No - thank you! I feel better!

Doctor DanB :Great. Good luck! Your feedback is important to me and will help me improve my encounter with future customers. If at any time you feel this process has been helpful, please rate your encounter with me by providing feedback; any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied. My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!

Customer:

Thanks so much! You were extremely helpful and informative! Thanks again!

I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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